Prevalence and predictors of hepatitis B virus infection among sellers and workers at West Africa's largest market, Kejetia, Ghana

Hepatitis B virus (HBV) infection remains a major public health challenge in sub-Saharan Africa, including Ghana, despite the infant vaccination programs. Limited data exist on HBV prevalence and predictors in informal sector populations, who may face unique occupational and behavioural exposures. This study assessed the prevalence and predictors of HBV infection among sellers and workers at Kejetia Market, Ghanas largest commercial hub. A cross-sectional study was conducted among 489 adult market workers from 4th December, 2024 to 25th January, 2025. Participants were selected through stratified random sampling across occupational groups. Data on sociodemographic, occupational, and behavioural factors were collected using structured questionnaires. On-site testing for hepatitis B surface antigen (HBsAg) was performed using the Hightop One Step Rapid Test kit. Bivariate and multivariate logistic regression analyses were used to identify independent predictors of HBV infection. P < 0.05 was considered statistically significant. The overall prevalence of HBV infection was 7.36% (36/489), consistent with intermediate-to-high endemicity. Multivariate analysis identified three independent predictors of HBV infection. Female gender (aOR = 0.455, 95% CI: 0.221-0.937; p = 0.033) and absence of tattoos (aOR = 0.283, 95% CI: 0.110-0.730; p = 0.009) were associated with lower risk of HBV infection, while unvaccinated individuals had 3.37-fold increased odds of getting the infection (95% CI: 1.395- 8.142; p = 0.007). HBV prevalence declined progressively with increasing vaccine doses, from 9.2% in unvaccinated individuals to 2.3% among those who had completed three or more doses. HBV infection is common among Kejetia market workers, with prevalence exceeding both continental and global estimates. Gender, tattooing, and vaccination status were significant predictors of infection. Strengthening adult vaccination programs, promoting safe tattooing practices, and implementing male-focused screening and prevention interventions are critical to reducing HBV burden and achieving Ghanas contribution to the WHO goal of eliminating HBV by 2030.